Table 2.
Risk of Childhood Overweight and Obesity by Maternal Glucose & Weight Gain
| Childhood BMI > 85%ile | Childhood BMI > 95%ile | ||||
|---|---|---|---|---|---|
| HR(95%CI)a | AR% (95%CI)b | HR(95%CI)a | AR% (95%CI)b | ||
| Maternal Glucose c | |||||
| Normal GCT | reference | reference | |||
| GCT+, no GDM | 1.15 (1.05-1.25) | 9.2 (4.3-14.1) | 1.23 (1.10-1.38) | 15.8 (8.7-23.0) | |
| GDM | 1.31 (1.16-1.47) | 15.8 (9.3-22.3) | 1.39 (1.20-1.62) | 28.5 (15.1-41.1) | |
| Maternal Weight Gain | |||||
| <=40 pounds (18.1 kg) | reference | reference | |||
| > 40 pounds d | 1.17 (1.09-1.25) | 12.9 (8.5-17.5) | 1.19 (1.09-1.31) | 16.4 (9.4-23.2) | |
Hazards ratio (HR) adjusted for maternal age, parity, baby gender, nonwhite race, and child birth-year
Attributable risk percent (AR%) for childhood overweight (BMI>85%ile) and obesity (BMI>95%ile)
Women were universally screened for gestational diabetes (GDM) by a 50g 1- hour non-fasting glucose challenge test (GCT), and if GCT was positive (+) >=7.8 mmol/L (>=140 mg/dl)), a 100g 3- hour fasting oral glucose tolerance test (OGTT) to diagnose GDM. GDM is defined by C&C criteria (2 or more of 4 possible glucose concentrations measured with the 100g OGTT are positive: Fasting >95 mg/dl [5.3 mmol/l]; 1hr >180 mg/dl [10 mmol/l]; 2hr >155 mg/dl [8.6 mmol/l]; 3hr >140 mg/dl [7.8 mmol/l]) (American College of Obstetricians and Gynecologists 2013)
Excessive maternal weight gain for all pre-pregnancy BMI categories is defined as >40 pounds (18.1 kg) by Institute of Medicine (IOM) guidelines (Institute of Medicine of the National Academies 2009).